The Impact of Lymphovascular Invasion on Risk of Upstaging and Lymph Node Metastasis at the Time of Radical Cystectomy

Werntz, Ryan P.; Smith, Zachary L.; Packiam, Vignesh T.; Smith, Norm D.; Steinberg, Gary D.

doi:10.1016/j.euf.2018.09.019

Cited by 18 publications

(11 citation statements)

References 14 publications

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“…Malignant tumor cell metastasis is the leading cause of death in patients with malignant tumors, in which lymphatic metastasis is the main way. Lymph vascular invasion (LVI) refers to the infiltration of tumor cells in the lumen of arteries, veins, or lymphatic vessels during histologic examination with hematoxylin and eosin (H&E) stains, D2-40 and CD31 stains, which has previously been demonstrated to prompt the local recurrence and distant metastasis of tumors ( 5 , 6 ). For instance, LVI has been reported to be an independent prognostic factor for the overall survival (OS) and disease-free survival (PFS) of breast cancer patients ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Radiomics in Gastric Cancer: First Clinical Investigation to Predict Lymph Vascular Invasion and Survival Outcome Using 18F-FDG PET/CT Images

Yang

Chu

et al. 2022

Front. Oncol.

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BackgroundLymph vascular invasion (LVI) is an unfavorable prognostic indicator in gastric cancer (GC). However, there are no reliable clinical techniques for preoperative predictions of LVI. The aim of this study was to develop and validate PET/CT-based radiomics signatures for predicting LVI of GC preoperatively. Radiomics nomograms were also established to predict patient survival outcomes.MethodsThis retrospective study registered 148 GC patients with histopathological confirmation for LVI status, who underwent pre-operative PET/CT scans (Discovery VCT 64 PET/CT system) from December 2014 to June 2019. Clinic-pathological factors (age, gender, and tumor grade, etc.) and metabolic PET data (maximum and mean standardized uptake value, total lesion glycolysis and metabolic tumor volume) were analyzed to identify independent LVI predictors. The dataset was randomly assigned to either the training set or test set in a 7:3 ratios. Three-dimensional (3D) radiomics features were extracted from each PET- and CT-volume of interests (VOI) singularly, and then a radiomics signature (RS) associated with LVI status is built by feature selection. Four models with different modalities (PET-RS: only PET radiomics features; CT-RS: only CT radiomics features; PET/CT-RS: both PET and CT radiomics features; PET/CT-RS plus clinical data) were developed to predict LVI. Patients were postoperatively followed up with PET/CT every 6-12 months for the first two years and then annually up to five years after surgery. The PET/CT radiomics score (Rad-scores) was calculated to assess survival outcome, and corresponding nomograms with radiomics (NWR) or without radiomics (NWOR) were established.ResultsTumor grade and maximum standardized uptake value (SUVmax) were the independent LVI predictor. 1037 CT and PET 3D radiomics features were extracted separately and reduced to 4 and 5 features to build CT-RS and PET-RS, respectively. PET/CT-RS and PET/CT-RS plus clinical data (tumor grade and SUVmax) were also developed. The ROC analysis demonstrated clinical usefulness of PET/CT-RS plus clinical data (AUC values for training and validation, respectively 0.936 and 0.914) and PET/CT-RS (AUC values for training and validation, respectively 0.881 and 0.854), which both are superior to CT-RS (0.838 and 0.824) and PET-RS (0.821 and 0.812). SUVmax and LVI were independent prognostic indicators of both OS and PFS. Decision curve analysis (DCA) demonstrated NWR outperformed NWOR and was established to assess survival outcomes. For estimation of OS and PFS, the C-indexes of the NWR were 0. 88 and 0.88 in the training set, respectively, while the C-indexes of the NWOR were 0. 82 and 0.85 in the training set, respectively.ConclusionsThe PET/CT-based radiomics analysis might serve as a non-invasive approach to predict LVI status in GC patients and provide effective predictors of patient survival outcomes.

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Section: Introductionmentioning

confidence: 99%

Radiomics in Gastric Cancer: First Clinical Investigation to Predict Lymph Vascular Invasion and Survival Outcome Using 18F-FDG PET/CT Images

Yang

Chu

et al. 2022

Front. Oncol.

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“…Частота обнаружения лимфоваскулярной инвазии в образцах резецированной при ТУРМП ткани, по данным крупных многоцентровых исследований, составляет в среднем 30 % [82,83]. Исследование В. Goldsmith и соавт.…”

Section: рекомендации по проведению нхт при тмт: • выполнение нхт пер...unclassified

Guideline on trimodal therapy of bladder cancer (Nevskiy consensus 2021)

Novikov

Новиков

et al. 2022

Onkourologiâ

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The aim of this work was to clarify and extend the existing clinical guidelines on organ-sparing treatment of muscleinvasive bladder cancer. The standard protocol of radical conservative treatment for muscle-invasive bladder cancer includes transurethral resection of the bladder, external beam radiotherapy with simultaneous chemotherapy (radiosensitization), which is usually referred to as trimodal therapy. The implementation of trimodal therapy into routine practice in Russia is limited due to the lack of distinct criteria for each of the stages. The involvement of surgeons, radiation oncologists, and chemotherapists, on the one hand, provides the required multidisciplinary approach to cancer treatment; on the other hand, it might impede the entire algorithm. To address this problem, specialists from the Department of Radiology (project moderators), Department of Cancer Urology, and Department of Chemotherapy of N.N. Petrov National Medical Research Center of Oncology under the auspices of Saint Petersburg Oncological Research Society formed a group of experts, including radiation oncologists, urologists, and chemotherapists from federal and local cancer (educational) institutions of Saint Petersburg who had an experience of treating muscle-invasive bladder cancer. The guideline was developed with the consideration of available guidelines published by leading professional associations of radiotherapy and oncology (urological), research articles, and own experience.

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“…In patients with HG/G3 T1 tumors after adjuvant instillations of BCG, the risk of recurrence can be assessed using clinical and pathologic variables such as tumor size, age, smoking status and presence of carcinoma in situ [7], gender [8], multifocality of tumors [9], neutrophil-to-lymphocyte ratio (NLR) [10] and the diagnosis of HG/G3 T1 tumors on re-transurethral resection of bladder tumor (TURBT) [11]. Body mass index (BMI) [9,12], as well as lymph-vascular invasion (LVI) and LVI at re-TURBT [13,14], affects the risk of recurrence and progression. It is well known that systemic inflammation plays a key role in solid tumors and measuring C-reactive protein (CRP) represents a rapid and relatively cheap prognostic circulating biomarker [15].…”

Section: Introductionmentioning

confidence: 99%

Modified Glasgow Prognostic Score as a Predictor of Recurrence in Patients with High Grade Non-Muscle Invasive Bladder Cancer Undergoing Intravesical Bacillus Calmette–Guerin Immunotherapy

et al. 2022

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Background: A systemic inflammatory marker, the modified Glasgow prognostic score (mGPS), could predict outcomes in non-muscle-invasive bladder cancer (NIMBC). We aimed to investigate the predictive power of mGPS in oncological outcomes in HG/G3 T1 NMIBC patients undergoing Bacillus Calmette–Guérin (BCG) therapy. Methods: We retrospectively reviewed patient’s medical data from multicenter institutions. A total of 1382 patients with HG/G3 T1 NMIBC have been administered adjuvant intravesical BCG therapy, every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months. The analysis of mGPS for recurrence and progression was performed using multivariable and univariable Cox regression models. Results: During follow-up, 659 patients (47.68%) suffered recurrence, 441 (31.91%) suffered progression, 156 (11.28%) died of all causes, and 67 (4.84%) died of bladder cancer. At multivariable analysis, neutrophil to lymphocyte ratio [hazard ratio (HR): 7.471; p = 0.0001] and erythrocyte sedimentation rate (ESR) (HR: 0.706; p = 0.006 were significantly associated with recurrence. mGPS has no statistical significance for progression (p = 0.076). Kaplan–Meier survival analysis showed a significant difference in survival among patients from different mGPS subgroups. Five-year OS was 93% (CI 95% 92–94), in patients with mGPS 0, 82.2% (CI 95% 78.9–85.5) in patients with mGPS 1 and 78.1% (CI 95% 60.4–70) in mGPS 2 patients. Five-year CSS was 98% (CI 95% 97–99) in patients with mGPS 0, 90% (CI 95% 87–94) in patients with mGPS 1, and 100% in mGPS 2 patients. Limitations are applicable to a retrospective study. Conclusions: mGPS may have the potential to predict recurrence in HG/G3 T1 NMIBC patients, but more prospective, with large cohorts, studies are needed to study the influence of systemic inflammatory markers in prediction of outcomes in NMIBC for a definitive conclusion.

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The Impact of Lymphovascular Invasion on Risk of Upstaging and Lymph Node Metastasis at the Time of Radical Cystectomy

Cited by 18 publications

References 14 publications

Radiomics in Gastric Cancer: First Clinical Investigation to Predict Lymph Vascular Invasion and Survival Outcome Using 18F-FDG PET/CT Images

Radiomics in Gastric Cancer: First Clinical Investigation to Predict Lymph Vascular Invasion and Survival Outcome Using 18F-FDG PET/CT Images

Guideline on trimodal therapy of bladder cancer (Nevskiy consensus 2021)

Modified Glasgow Prognostic Score as a Predictor of Recurrence in Patients with High Grade Non-Muscle Invasive Bladder Cancer Undergoing Intravesical Bacillus Calmette–Guerin Immunotherapy

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